The Truth Squad has talked it over and decided we should go out of business the minute a repeal bill is signed. Our role in all this has been to bring you all the bad news about Obamacare every day so you could keep the pressure on. That role is coming to an end but, until then, we’ll keep giving you ammunition to fight this very bad law. That includes Medicaid expansion, which few people pay attention to, but is yet another massive Obamacare train wreck unfolding before our eyes.
We will also speak up when we see policy going in the wrong direction, and that’s what I will do tonight.
President-elect Trump has signaled that he may propose keeping guaranteed issue for people with preexisting conditions and the Obamacare slacker mandate allowing ‘adult children’ to stay on their parents’ plan to age 26. This is in line with his previous statements, and consistent with Republican replacement proposals.
While these are the most popular parts of Obamacare, keeping them would be a very bad idea for several reasons:
- The retention of coverage mandates prevents the return of true catastrophic insurance, a common sense solution to rising insurance costs. If this happens, the movement for nullification of federal law to legalize catastrophic insurance will continue.
- Further, the retention keeps the federal government in the business of regulating insurance, a business it first entered in Obamacare with disastrous results.
- What insurance company is going to write a policy covering preexisting conditions all on its own? Keeping guaranteed issue would require subsidies and mandates, just like Obamacare. Several previous Republican and think tank proposals are built around a ‘universal tax credit’ which would amount to a subsidy, a federal guarantee that would continue to fuel the government-healthcare industrial complex, distort market pricing, and push costs up. Wrong direction. If a subsidy of preexisting conditions is desired, state high-risk pools – of the kind that existed in some 35 states before Obamacare – would be a much better way to go.
- The individual mandate was added to Obamacare to convince insurers they would be receiving millions of government-guaranteed customers to spread the cost of preexisting conditions among a pool large enough to handle it. The individual mandate or some coercive substitute would have to stay if guaranteed issue is preserved.
- Guaranteed issue – an idea that failed in several states and is blowing up before our very eyes in Obamacare – would set up Trump’s new system for all the problems of Obamacare – adverse selection and the potential for an insurance death spiral.
Things are starting to look like Congress and the new administration will pretend to repeal Obamacare, only to bring most of it back under another name. Such rebranding efforts have taken place in several states that purported to ‘get rid of Common Core’ in the education space.
Keeping guaranteed issue would be a mistake. We don’t like the way things are shaping up. Full repeal is still the way to go, in our book.
Partial Repeal Won’t Work #7 – preexisting conditions attracts sick, insurers compete not to offer best coverage
Partial Repeal Won’t Work #6 – separate insurance for health status possible solution
Partial Repeal Won’t Work #5 – insurers warn guaranteed issue w/o a mandate leads to ins death spiral
Partial Repeal Won’t Work #4 – penalties to substitute for individual mandate don’t look so great
Partial Repeal Won’t Work #3 – keeping preexisting conditions requires keeping individual mandate
Partial Repeal Won’t Work #2 – guaranteed issue blew up in states that tried it, just like Obamacare
Partial Repeal Won’t Work #1 – guaranteed issue would require subsidies and mandates, just like Obamacare.